Medicare expenditures for advanced dementia patients vary widely, study shows

Share this article:

Implementing high-quality palliative care programs for nursing home residents with advanced dementia could prevent expensive hospitalizations and burdensome interventions, such as feeding tubes, a new study finds.

Due to a lack of data regarding end-of-life Medicare expenditures in nursing home patients with severe dementia, researchers from Columbia University, Harvard Medical School, Beth Israel Deaconess Medical Center and Hebrew SeniorLife Institute for Aging Research studied 323 residents at nearly two dozen nursing facilities over a period of 18 months. The total mean Medicare expenditures during that period were $2,303 per 90 days, but that number is highly skewed. Expenditures were less than $500 for 77% of assessments but more than $12,000 for 5.5%. Among the 177 study subjects who died, mean Medicare expenditures increased by 65% in each of the last four quarters before death due to an increase in hospice and acute care.

Patients living in specialized units, who did not have feeding tubes and who had do-not-hospitalize orders, had lower Medicare expenditures than those undergoing more aggressive treatments, the investigators found.

“Strategies that promote high-quality palliative care may shift expenditures away from aggressive treatments for these patients at the end of life,” wrote the researchers. The study was published in the Archives of Internal Medicine.

Share this article:

More in News

Nursing home antipsychotic use has dipped nearly 19% under national effort, latest figures show

Nursing home antipsychotic use has dipped nearly 19% ...

The percent of long-stay nursing home residents receiving antipsychotic medication has decreased 18.8% under a nationwide initiative that started in 2012, according to the most recent quarterly figures from the ...

Jimmo succeeds in getting Medicare coverage, two years after landmark case ended

Glenda Jimmo has reached a settlement with the federal government and will finally receive Medicare coverage for claims that were denied in 2007, which led her to file a class-action lawsuit over the so-called "improvement standard."

Also in the news for Oct. 31, 2014 . . .

Minnix hopes White House aging conference will spur 'huge shift' ... CMS finalizes home health payment reductions ... Dementia is now No. 1 killer of women in England